MEDICARE: MEGAN BATESON BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst
2	247200000X	Other Technician
3	106E00000X	Assistant Behavior Analyst	7402000077	MI

General Provider Information

NPI Number	:	1790227163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN BATESON BS

Provider Business Mailing Address
First Line	:	405 W GREENLAWN AVE STE 200
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2889
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 W GREENLAWN AVE STE 200
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2889
Country	:	US
Telephone Number	:	517-657-2638
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	02/17/2025

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